Healthcare Provider Details

I. General information

NPI: 1588959852
Provider Name (Legal Business Name): COMPLETE SOLUTIONS FOR LIFE,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2011
Last Update Date: 05/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 W 117TH ST APT 7F
NEW YORK NY
10026-2108
US

IV. Provider business mailing address

203 W 117TH ST APT 7F
NEW YORK NY
10026-2108
US

V. Phone/Fax

Practice location:
  • Phone: 646-269-5777
  • Fax:
Mailing address:
  • Phone: 646-269-5777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. PATRICIA LYNN SMITH
Title or Position: OWNER/DIRECTOR
Credential: MA
Phone: 646-269-5777